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Despite increases in cases of Lyme disease, little is known about the management and clinical course of the disease in Canada. We aimed to describe the management and clinical course of Lyme disease in patients treated in acute care facilities in Quebec and to assess adherence to the 2006 Infectious Diseases Society of America (IDSA) guideline.This retrospective multicentre cohort study included pediatric and adult patients with serologically confirmed Lyme disease treated in acute care facilities (12 community hospitals and 2 tertiary care centres) of 2 endemic regions of Quebec (Estrie and Montérégie), from 2004 to 2017. We considered drug choice, prescribed dose and treatment duration in assessing adherence of prescriptions to the 2006 IDSA guideline. The main outcome was complete resolution of symptoms at 3 months after the initiation of treatment.We included 272 patients from 14 institutions (age range 3-87 yr). Early disseminated Lyme disease (140 patients [51%]) was predominant. Adherence to the IDSA guideline was observed in 235 (90%) of the 261 cases with complete information, and adherence was stable over time (2004-2013: 57/64 [89%]; 2014-2015: 64/71 [90%]; 2016-2017: 114/126 [90%];We observed clinical resolution of Lyme disease in 99% of the patients, and most treatments (90%) complied with the 2006 IDSA guideline. The incidence of post-treatment Lyme disease syndrome increased over the study period, warranting further prospective studies.

The historical dimension of biology attests to the various conceptions of living organisms that have governed the construction of scientific knowledge over time, some of which still persist today. ...

This article outlines the results from the research on primary and secondary school pupils’ conceptualisation of microorganisms. It has been observed from the past few decades that one conceptual m...

International audience

Objectives To compare: 1) 75 g oral glucose tolerance test (OGTT) and self-monitoring of blood glucose (SMBG) in identifying gestational diabetes mellitus (GDM) and other hyperglycemic statuses in pregnant women; 2) pregnancy outcomes according to glycemic status; and 3) participants’ opinions regarding both methods. Methods A prospective study in women with a 50 g glucose load test ≥7.2 mmol/L at 24 to 28 weeks’ gestation and singleton pregnancy. Women underwent OGTT (blinded) at day 1, followed by 7 days of SMBG (4 daily measurements: fasting and 2 h postprandially) without modifying diet or lifestyle. GDM (OGTT+) was diagnosed using the criteria of the International Association of the Diabetes and Pregnancy Study Groups, while pregnancy hyperglycemia (SMBG+) was defined as ≥4/7 glucose values ≥5.3 after fasting or ≥6.7 mmol/L 2 h postprandially for any meal of the day. Equivalent management was provided to women with GDM and/or pregnancy-related hyperglycemia. Results We divided 103 participants (age: 29.5±5.0 years; prepregnancy body mass index: 25.3±5.4 kg/m2) into 4 groups according to test results: OGTT+/SMBG+ (n=12, 11.7%); OGTT+/SMBG– (n=14, 13.6%); OGTT–/SMBG+ (n=9, 8.7%); and OGTT–/SMBG– (n=68, 66.0%). Clinical characteristics and maternal outcomes were statistically similar between groups. Neonatal complication rates were greater in groups with hyperglycemia than in the OGTT–/SMBG– group, notably neonatal hypoglycemia (9/12, 7/14, 5/9 vs. 6/68; p Conclusions More than half of the women with OGTT+ were normoglycemic in daily life. Conversely, 11.7% of women with OGTT– had pregnancy hyperglycemia. OGTT+ and/or SMBG+ were equally associated with greater neonatal complications. This study suggests that alongside OGTT, SMBG could improve the care of pregnant women.

Au cours des dernieres decennies, la recherche en didactique de la biologie s’est attardee a differents problemes, dont ceux relies a l’identification de conceptions et d’obstacles, a l’analyse de situations didactiques et de processus d’apprentissage. A cet effet, Astolfi (1992) concoit « l’obstacle comme un veritable outil didactique au service des apprentissages ». En continuite avec les travaux de Jean-Pierre Astolfi, la presente recherche etudie les conceptions sur le vivant de futurs enseignants et/ou biologistes (N = 543), dont certaines d’entre elles sont des obstacles a une conceptualisation contemporaine du vivant. Descriptive et exploratoire, cette etude evoque la presence de conceptions historiques sur le vivant qui perdurent en co-acceptation avec celles en adequation aux savoirs biologiques actuels. Les resultats temoignent de la presence de cinq composantes constituees des conceptions animiste, vitaliste, finaliste, evolutionniste, interactionniste, deterministe hereditaire et deterministe comportemental, dont certaines sont des obstacles epistemologiques historiques. Ces obstacles, formes d’explications animiste et vitaliste, finaliste et deterministe comportemental, sont observes chez 51,9 %, 82,4 % et 44,0 % des repondants. La presence de ces conceptions s’insere dans une reflexion d’objectif-obstacle en situation d’enseignement et d’apprentissage.

Au «stade du miroir», caractérisé par la reconnaissance par l'enfant de sa propre image dans le miroir et par l'approbation qu'il perçoit simultanément chez l'adulte dont il découvre également le reflet, on peut opposer une expérience qui a lieu au cours du vieillissement : c'est l'expérience, dite dans l'article, du «miroir brisé» qui se situe au moment où l'image renvoyée par le miroir n'est plus conforme à ce que le sujet en attendait. Cette expérience remet en cause non seulement le rapport du sujet à lui-même, mais aussi à l'autre, qui depuis le stade du miroir, avait servi de garant identificatoire au sujet. Se découvrir soi-même autre et différent, se confronter à un autre avec lequel on ne peut plus s'aliéner dans la similitude, c'est cette rencontre de l'altérité qui est l'enjeu de l'expérience du miroir brisé et qui vient battre en brèche la complaisance narcissique. La dynamique de l'altérité invite alors à un dévoilement (illustrée par la tragédie d'«Oedipe à Colone») et le destin de l'expérience du miroir brisé se situe entre perdition et désaliénation du sujet., The "mirror phase" is characterized by a child's recognition of his own image in the mirror and simultaneous perception of approval by the adult, whose reflection is equally discovered. In contrast to this phase, we identify an experience that takes place in old age: the experience referred to in this article as the «shattered mirror», which occurs when the image reflected by the mirror no longer matches the expectations of the subject. This experience raises doubts concerning non only the relation of the subject with himself, but also with the other, who, ever since the "mirror phase", has supported the subject's identity. Encountering alterity, the process of discovering one's self as different and of confronting an other with whom similarities no longer hold true, is the crux of the "shattered mirror' ' experience and the basis for uprooting narcissist complacency. The dynamics of alterity therefore favour revealment (illustrated by the tragedy of "Oedipe à Colone", while the outcome of the "shattered mirror" experience ranges between distress and reduced alienation.

Dans ce texte nous définirons d'abord, en référence à Erikson, la notion d'identité ; nous montrerons comment cette identité s'inscrit dans une culture donnée, laquelle offre un soutien à l'individu. Ensuite, nous verrons comment ce support culturel nécessaire à la construction de l'identité fait défaut aux personnes vieillissantes mises à la retraite, provoquant ainsi chez elles une « crise d'identité ». Enfin nous expliquerons comment ce phénomène engendre chez les personnes âgées une psychologie de compensation et des attitudes typiques de membres de groupe minoritaire., After having shown how each culture allows the individual to trow his "sameness" into identity, psychosocial identity, significant for himself and his community, we explain how this cultural support fails for the elderly person reaching retirement. We then see how the impossibility of a congruent relationship between the personal identity and dominant social values provokes in the elderly person a chain of defensive and compensatory behaviour often labelled as being due to an intrinsically involutionary psychology of aging. Finally, we show how this is the lot of the members of all minority groups and that, in fact, old people have the characteristics of a minority group. 32

Les percees en matiere de biotechnologie ouvrent la voie a des transformations d’une grande portee touchant au coeur du vivant : manipulation genetique, OGM ou utilisation de cellules souches, la biologie contemporaine souleve des questions porteuses d’enjeux qui trouvent echo dans la recherche et l’enseignement des sciences. Dans ce contexte, nous avons mene une etude sur l’analyse du discours des programmes officiels scolaires du prescolaire au secondaire en France et au Quebec sur les questions entourant le vivant, en considerant que lesdits programmes contribuent autant a la structuration des situations educatives qu’a l’integration d’un point de vue sur la societe et les savoirs. L’etude a ete realisee au regard de trois modes de questionnement : caracterisation du vivant, approches ethiques du vivant et methodologies scientifiques et techniques. Les resultats de l’analyse montrent une evolution comparable des activites experimentales suggerees au cours de la scolarite dans les deux pays. Celles-ci convoquent une pluralite de demarches (et non une seule et meme demarche scientifique) et proposent des tâches ouvertes aux eleves visant a leur donner de l’autonomie. Sur beaucoup de plans, les attentes semblent s’appuyer, en partie, sur un modele socioconstructiviste de l’acquisition des connaissances. Les facons de favoriser les rencontres du « vivant » different quant a elles.

Cette étude présente une lecture des dossiers académiques d’étudiants ayant complété une formation universitaire en éducation préscolaire et en enseignement primaire afin de vérifier la validité et la fiabilité des évaluations réalisées durant cette formation. L'importance de facteurs tels que la cote de rendement au collège des étudiants, l'équivalence entre deux campus universitaires et les années de diplomation, ainsi que l’équité entre le genre et l'âge des étudiants est également investiguée. La base de données se compose des dossiers académiques de 873 finissants du programme d'éducation préscolaire et d’enseignement primaire ayant gradué entre 2006 et 2012 dans l'un ou l'autre des deux campus de l'Université du Québec à Rimouski. Les résultats de l’analyse factorielle suggèrent que les notes ne sont pas le produit d’un processus arbitraire et aléatoire. Ainsi, l’ensemble des notes aux cours du programme, telles qu’elles apparaissent dans le dossier académique des étudiants, se structure en facteurs qui permettent d’inférer, tel qu’attendu, la mesure de groupes de compétences interreliées. L’ensemble possède une bonne fiabilité. Des régressions multiniveaux montrent que la cote de rendement au collège est un bon prédicteur de la moyenne cumulative et qu’il y a équivalence en fonction du campus d’études et de l’année de diplomation. Cependant, il subsiste de légères iniquités dans la moyenne cumulative en fonction de l’âge et du genre de l’étudiant, iniquités qui ne sont pas liées aux succès académiques antérieurs. This study presents a reading of academic files of students having completed a bachelor degree in a preschool education and primary teaching curriculum in order to assess the validity and reliability of the underlying grades. The impact of factors such as previous college results, campus of study, year of diploma, gender and age are also investigated. The database is composed of 873 graduated students from the preschool education and primary teaching program, having graduated between 2006 and 2012 from one of the two campuses of the University of Quebec at Rimouski. The results of an exploratory factorial analysis suggest that the grades are not the product of random and arbitrary processes. Student grades according to their records are structured according to factors that, as expected, help measure four groups of connected learning outcomes. The set shows good reliability. Multiple level regressions reveal that past college performance is a good predictor of university mean grade point average (UGPA) with no impact of the university campus or the year of diploma. However, some slight iniquities remain in the UGPA as a function of students’ gender and age, once past academic success has been accounted for.

Objectives To determine the efficacy of pelvic floor muscle (PFM) rehabilitation for elderly women with urinary incontinence after five years of follow-up, and to assess the adherence to PFM exercises five years after physiotherapy. Methods We conducted a retrospective chart review of women ≥ 60 years old who underwent PFM physiotherapy for urinary incontinence between September 1999 and February 2004. PFM rehabilitation techniques were taught to patients by a certified physiotherapist. The mean number of sessions was eight. Telephone surveys were conducted at two months, six months, and one to five years after physiotherapy. Objective data on the efficacy of treatment (number of voids, incontinence, use of pads) and on adherence to PFM exercises were collected using a uniform grid. Data were used to determine the continence status at follow-up and compared with the data collected at the end of the PFM training sessions (improved, maintained, or deteriorated). Results Of 89 older women (mean age 70 years; range 60 to 81) treated during the study period, 40 were followed up to five years and were suitable for analysis. At five years of follow-up, 27.5% had improved, 57.5% remained stable, and 15% had deteriorated compared with their post-treatment continence status. Twenty-nine patients (72.5%) were continuing their PFM exercises, and 42.5% were performing the exercises daily. All adherent patients had "improved" or "stable" status after five years versus 45.5% of non-adherent patients ( P Conclusion Pelvic floor muscle rehabilitation for urinary incontinence remains highly effective for up to five years in older women. Most women continue to perform PFM exercises five years after completing their physiotherapy education sessions.

Thomas G Poder,1 Jie He,2 Catherine Simard,3 Jean-Charles Pasquier4 1UETMIS and CRCHUS, CHUS, Sherbrooke, QC, Canada; 2Department of Economics, GREDI, University of Sherbrooke, QC, Canada; 3Department of Obstetrics and Gynecology, CH of Chicoutimi, affiliated to CHUS, QC, Canada; 4Department of Obstetrics and Gynecology, CHUS, Sherbrooke, QC, Canada Objective: To measure the willingness to pay (WTP) of women aged 18–45 years to receive drug treatment for ovulation induction (ie, the social value of normal cycles of ovulation for a woman of childbearing age) in order to feed the debate about the funding of fertility cares.Setting: An anonymous questionnaire was used over the general population of Quebec. Participants: A total of 136 subjects were recruited in three medical clinics, and 191 subjects through an online questionnaire.Method: The questionnaire consisted of three parts: introduction to the problematic, socioeconomic data collection to determine factors influencing the formation of WTP, and a WTP question using the simple bid price dichotomous choice elicitation technique. The econometric estimation method is based on the “random utility theory.” Each subject responding to our questionnaire could express her uncertainty about the answer to our WTP question by choosing the answer “I do not know.”Outcome measure: The WTP in Canadian dollars of women aged 18–45 years to receive drug treatment for ovulation induction.Results: Results are positive and indicate an average WTP exceeding 4,800 CAD, which is much more than the drug treatment cost. There is no evidence of sample frame bias or avidity bias across the two survey modes that cannot be controlled in econometric estimates.Conclusion: Medical treatment for ovulation induction is highly socially desirable in Quebec. Keywords: WTP, fertility, drug therapy&nbsp

International audience; En ce XXIe siècle, le vivant est une question vive : que ce soit au niveau de la recherche en sciences et technologie, en éducation, dans la société et lors des débats sur l'érosion de la biodiversité ou la transformation du vivant, par exemple. Cet ouvrage, rapprochant la recherche et l'enseignement, arrive à point nommé pour l’Année de la biologie. Les divers chapitres abordent, sous des perspectives tantôt épistémologique, éthique, scientifique et citoyenne pour une éducation au vivant, différents enjeux qui gravitent autour de la question du vivant et de ses controverses. D’autres chapitres proposent des pistes de réflexion et des pratiques éducatives sur des sujets variés, dont la biodiversité, le statut des primates, la représentation des microorganismes et la légalisation du cannabis au Canada. Le volume contribue à ouvrir de nouvelles perspectives en résonance avec les défis actuels qui se posent au vivant comme question socialement vive.